Epidemiology of Inhalant Abuse - Archives - National Institute on ...

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senses worse: There have been very few prevention or treatment interventions directed at the inhalant programs, and there has been no effort to evaluate what little has been done. There is no explicit Federal policy with respect to inhalant abuse. Only a single act <strong>of</strong> Congress has been passed (Public Law 100-690), and that act dealt with only one small class <strong>of</strong> inhalants (nitrites) under the authority <strong>of</strong> the Consumer Product Safety Act. The only regulations specifically focusing on inhalant abuse were requirements for labeling <strong>of</strong> pressurized food and cosmetic products. There have been a few narrowly interpreted product-specific Federal regulatory actions for abused products over the past 25 years. However, there has been no systematic examination <strong>of</strong> the nature and extent <strong>of</strong> the problem, no effort to identify and evaluate policy options, and certainly no movement to articulate a coherent Federal posture on this matter. Federal policy on inhalants has been formulated by default: The Federal Government rarely has used regulation to either change products or restrict access to specific products in order to reduce abuse <strong>of</strong> inhalants. It should be noted that this is in contrast to Federal policy with respect to other consumer product and occupational safety issues, where there has been extensive legislation and regulation by agencies including the Consumer Product Safety Commission (CPSC), the Food and Drug Administration (FDA), and the Occupational Safety and Health Administration (OSHA). In contrast, 43 States have passed statutes specifically directed at inhalants. This is not to say that the States have arrived collectively at a coherent inhalant abuse policy, for this is far from the case. States have written and in some cases implemented (or not implemented) a vast array <strong>of</strong> policies with respect to inhalants: 41 States have criminal statutes regarding abuse <strong>of</strong> inhalants; 31 States have business regulations on product formulation or access; and 10 States have prevention or treatment-related statutes. Most laws attempt to limit access to inhalable products or change inhalable products. Fewer States have legislated on prevention or treatment initiatives or both. Supply reduction efforts have 275
predominated, but it seems clear that these various efforts have not achieved notable success, since few specific policies have been widely replicated across multiple States. Law enforcement and business <strong>of</strong>ficials advocate that more effort should be put into prevention efforts. However, there is only theory and little evidence to guide how this should be undertaken. Demand reduction efforts targeted at inhalants have been rare, and when performed they have not been evaluated. General drug abuse prevention efforts <strong>of</strong>ten ignore inhalants. The recent rigorous prevention evaluations (ALERT and Project STAR) have not examined impacts on inhalant abuse (Ellickson and Bell 1990; Pentz et al. 1989). BACKGROUND ON THE PROBLEM <strong>Inhalant</strong> abuse is a persistent part <strong>of</strong> the drug abuse problem in the United States. In the face <strong>of</strong> major progress against the abuse <strong>of</strong> illicit drugs over the past 13 years, there has been no apparent progress against inhalant abuse. <strong>National</strong> rates <strong>of</strong> use among adolescents and adults have remained relatively stable over this time period (figure 1). In 1991, an estimated 1.8 percent <strong>of</strong> adolescents aged 12-17 years used inhalants during the 30 days prior to the survey; this is not significantly different from 2.0 percent in 1988 and 2.2 percent in 1990. About 1.5 percent <strong>of</strong> young adults aged 18-25 years in 1991 used inhalants during the prior 30 days (<strong>National</strong> <strong>Institute</strong> on Drug <strong>Abuse</strong> 1993). <strong>National</strong> rates and trends do not adequately characterize the nature, extent, or impact <strong>of</strong> inhalant problems nor the attention dedicated to this problem. <strong>Inhalant</strong>s <strong>of</strong>ten are the first drugs abused by adolescents (including alcohol and tobacco), and Oetting and colleagues (1988) have concluded that inhalant abuse <strong>of</strong>ten is symptomatic <strong>of</strong> or correlated with emotional problems. There is a great need to develop and test theories about the causes (i.e., etiology) <strong>of</strong> inhalant abuse, as well as the definition <strong>of</strong> inhalant abuse (Beauvais and Oetting 1987). Such information is fundamental to the development <strong>of</strong> new and ultimately effective strategies against inhalant abuse. Interested readers are directed, for example, to <strong>National</strong> <strong>Institute</strong> on Drug <strong>Abuse</strong> Research Monograph 129 (Sharp et al. 1992). In addition, while inhalant abuse is endemic across the Nation, it has been detected in higher rates and even in epidemic proportions in some communities with a large minority population, particularly among 276
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National I
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ACKNOWLEDGMENT This monograph is ba
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Treatment Strategies for Volatile S
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extent of inhalant
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agencies. Dr. Carlini-Cotrim conclu
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prevalence, after alcohol and tobac
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Inhalant Use in th
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FIGURE 1. Lifetime prevalence for 1
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Reliability of the
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use beginning in 1987 when the surv
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TABLE 2. Current use of</st
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TABLE 3. Use of in
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TABLE 4. Inhalant
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TABLE 5. Lifetime prevalence and cu
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TABLE 7. Inhalant
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CONCLUSION Unlike other drugs in th
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AUTHORS Ruth W. Edwards, Ph.D. Rese
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Epidemiologic data were obtained fo
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perception of the
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Malaysia In Malaysia, the abuse <st
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The primary method of</stro
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them at least two to three times pe
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Curiosity is the most popular motiv
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Inhaling from a plastic bag: The vo
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(between US $0.04 and US $0.80) a d
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truant, who have money, and who are
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Edmondson, K. Review of</st
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Inhalant A
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Children working in the streets 280
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(1986), collected data on the preva
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Anecdotal information suggests that
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FIGURE 3. Psychological process mod
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ehavior. A secondary aim has been u
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REFERENCES ABC Communication. Consu
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Inhalant Use Among
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TABLE 1. Lifetime prevalence <stron
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TABLE 3. Lifetime prevalence <stron
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TABLE 4. Solvent use found for 1,83
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however, rarely is taken into consi
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TABLE 7. Weekly use (at least once
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TABLE 9. Use of dr
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Oetting, E.R.; Edwards, R.W.; and B
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RESULTS Prevalence Rates The findin
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TABLE 2. Use of in
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Incidence Rates Data from the surve
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TABLE 7. Use of in
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FIGURE 2(a). Proportion and number
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TABLE 8. Regression analysis: Use <
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TABLE 10(a). Mean age at first inha
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TABLE 13. Percentage of</st
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FIGURE 3. Opinion on health consequ
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The conduct of con
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Inhalant A
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The lack of epidem
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FIGURE 1. Substance abusers treated
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FIGURE 2. Drug used at initiation <
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The registered inhalant abusers ran
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medication, and jumping from a tall
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(with the main psychoactive compone
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In 1990, a World Health Organizatio
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FIGURE 7. Number of</strong
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of an epidemic, wh
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Oetting, E.R.; Beauvais, F.; and Ed
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FIGURE 1. Arrests for drug statute
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had inhaled the vapor from lacquer
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FIGURE 4. Numbers of</stron
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TABLE 3. Age appeared to consultati
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TABLE 5. Present occupational situa
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FIGURE 5. SOURCE: Longitudnal patte
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FIGURE 7. Longitudinal pattern <str
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Epidemiology <stro
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TABLE 1. National
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(Hughes et al. 1980). The system ha
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TABLE 2. National
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TABLE 3. National
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FIGURE 1. National
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FIGURE 3. Drug Registry System (SRI
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TABLE 5. National
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TABLE 6. National
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TABLE 7. National
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TABLE 9. National
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TABLE 9. National
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TABLE 10. National
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TABLE 10. National
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The longest running institution, th
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Several programs have been develope
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Thus, substance abuse research has
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3. Alcohol and tobacco were not con
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Leal, H., and Pacheco, G. Estrategi
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Division of <stron
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mind the fact that a sizeable numbe
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Adults and Older Students I
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Method Participants. Participants w
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TABLE 6. Types of
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TABLE 9. Sources of</strong
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THE NEED FOR MORE RESEARCH ON INHAL
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funding. However, by encouraging th
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AUTHOR Isidore Silas Obot, Ph.D., M
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abuse and their biomedical, social,
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nitrites—is virtually unknown in
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TABLE 3. Frequency of</stro
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TABLE 5. Lifetime prevalence and cu
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working with children living in the
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of the youthful po
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Lucchini, R. “Niños Callejeros y
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least as far back as 1983. However,
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TABLE 1. Phase-out schedule for ozo
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inquisitorial, unlike the procedure
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UNITED KINGDOM VSA-RELATED MORTALIT
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FIGURE 5. United Kingdom VSA-relate
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TABLE 2. United Kingdom VSA-related
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TABLE 4. United Kingdom VSA-related
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Page 229 and 230: NATIONAL VSA STATISTICS The only <s
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Page 233 and 234: TABLE 7. Local surveys giving infor
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Page 237 and 238: presented as a confidential “Scho
Page 239 and 240: TABLE 8. Surveys of</strong
Page 241 and 242: Children’s Act 1989: Section 17 r
Page 243 and 244: problem would go away like other te
Page 245 and 246: Children ages 14-16 “should have
Page 247 and 248: contributions from many small group
Page 249 and 250: Chadwick, O.; Anderson, R.; Bland,
Page 251 and 252: Market and Opinion Research Interna
Page 253 and 254: Streete, P.J.; Ruprah, M.; Ramsey,
Page 255 and 256: Treatment Strategies for Volatile S
Page 257 and 258: that they chose solvents not only b
Page 259 and 260: Medical management and detoxificati
Page 261 and 262: challenges to a healthy readjustmen
Page 263 and 264: REFERENCES Beauvais, F. Social and
Page 265 and 266: Gathering Epidemiologic Information
Page 267 and 268: DIRECT POPULATION SURVEYS Cross-sec
Page 269 and 270: The findings in the two surveys wer
Page 271 and 272: TABLE 1. Recent use a of</s
Page 273 and 274: are due to the fact that inhalants
Page 275 and 276: number usually is advertised in tel
Page 277 and 278: REFERENCES Beauvais, F. Volatile so
Page 279: Inhalants: A Polic
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Page 285 and 286: justify their positions more on pri
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Page 289 and 290: with abuse potential, and additiona
Page 291 and 292: TABLE 2. Type of l
Page 293 and 294: TABLE 3. Type of d
Page 295 and 296: TABLE 4. Type of b
Page 297 and 298: TABLE 5. Specified products regulat
Page 299 and 300: TABLE 6. Prevention curricula and i
Page 301 and 302: appear to enter treatment that prog
Page 303 and 304: Policy Alternative 1: Change Produc
Page 305 and 306: outcome evaluations. Ideally, such
Page 307 and 308: Mata, A.G., Jr., and Andrew, S.R. <
Page 309 and 310: Recommendations and Conclusions Zil
Page 311 and 312: AUTHORS Zili Sloboda, Sc.D. Nichola
Page 313 and 314: 26 42 50 52 53 54 56 61 62 THE BEHA
Page 315 and 316: 80 82 83 84 85 87 88 89 92 NEEDLE S
Page 317 and 318: 102 106 107 108 109 111 112 113 ANA
Page 319 and 320: 124 NEUROBIOLOGICAL APPROACHES TO B
Page 321 and 322: 138 139 140 141 142 143 IMAGING TEC
Page 323: NIH Publication No 95-3831 Printed
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